Causes and Diagnoses

Causes and Diagnoses of Pelvic Organ Prolapse

There are a number of things that may cause damage or weakening to the pelvic floor. These may include:

• Pregnancy and childbirth: As many as one in three women who have given birth develop prolapse. Pregnancy and vaginal delivery can damage the pelvic muscles and nerves, allowing pelvic organs to descend. This can occur more commonly in women who delivered a large baby, required a forceps delivery, or have had many babies. Prolapse can occur shortly after pregnancy or may take many years to develop.
• Aging and menopause: Pelvic organ prolapse becomes more common with age, as loss of estrogen and other changes that occur with aging can weaken the pelvic floor muscles and support.
• Health conditions: Certain health conditions that involve repeated straining, including: obesity, chronic coughing and constipation can weaken and injure the pelvic floor muscles over time.
• Genetics/family history: The strength of your connective tissues is determined by your genetics. If your mother had pelvic organ prolapse, you are more likely to develop it.

If you have symptoms of pelvic organ prolapse, it is important that you consult with your primary care physician for a complete physical examination of the genitourinary and nervous systems, as well as provide your physician with urine samples.

If you are experiencing pelvic organ prolapse, your urogynecologist may recommend a variety of tests to diagnose the condition. A urogynecologist has done fellowship training and specializes in diseases and disorders of the female genitourinary tract. In addition to conducting a physical exam, a urogynecologist may conduct tests that could include:

• 3D pelvic ultrasound: An ultrasound that looks at the anatomy of the pelvic floor muscles.
• Postvoid residual urine volume: A small catheter is used to obtain a urine sample to ensure the bladder empties completely and there is no infection in the urine.
• Urodynamics: Urodynamics is a test to determine how the bladder functions. Some women with prolapse also have lower urinary tract symptoms such as difficulty passing urine, urinary incontinence, or frequent urination.